Provider Demographics
NPI:1023232725
Name:BUETTNER, ANNE YU (MA)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:YU
Last Name:BUETTNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 S BROADWELL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-6243
Mailing Address - Country:US
Mailing Address - Phone:308-383-7000
Mailing Address - Fax:308-384-7968
Practice Address - Street 1:714 SOUTH BROADWELL AVENUE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-6243
Practice Address - Country:US
Practice Address - Phone:308-383-7000
Practice Address - Fax:308-384-7968
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025070400Medicaid